| NPI | 1821454158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 006426) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 006426) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CT 006426) | |
| Enumeration Date | 2015-12-31 |
| Last Update Date | 2017-11-06 |