| NPI | 1790868883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NE 16458) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 16458) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2019-01-08 |