| NPI | 1790100790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9413869) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 5638) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 5638) | |
| Enumeration Date | 2014-02-27 |
| Last Update Date | 2018-03-08 |