| NPI | 1790480994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R234837) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R234837) |
| 363LF0000X Nurse Practitioner, Family (Licence: MD R234837) | |
| Enumeration Date | 2023-04-05 |
| Last Update Date | 2025-01-06 |