| NPI | 1801250816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R185028) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: MD R185028) |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2024-04-03 |