| NPI | 1790951846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 119780) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 44584) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 119870) | |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2015-10-13 |