| NPI | 1790872158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61079012) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN222518) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA 260064) | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2025-04-14 |