| NPI | 1811452360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC APN.26759RX) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9511807) |
| 164W00000X Licensed Practical Nurse (Licence: FL PN5228001) | |
| Enumeration Date | 2019-02-08 |
| Last Update Date | 2023-09-26 |