| NPI | 1790126670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R162214) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R162214) |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2024-06-13 |