| NPI | 1841700259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 21316) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: SC 21316) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G163389) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID 68624) | |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2021-08-24 |