| NPI | 1790161263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5007819) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5007819) |
| Enumeration Date | 2015-08-06 |
| Last Update Date | 2023-11-01 |