| NPI | 1821209677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R242409) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DE LO-0000101) |
| 363L00000X Nurse Practitioner (Licence: MD R242409) | |
| 363LF0000X Nurse Practitioner, Family (Licence: DE LG-0000668) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: DE L8-0000180) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2022-02-08 |