| NPI | 1902903321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WY 19355.0277) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID NP-629A) |
| 363LF0000X Nurse Practitioner, Family (Licence: MT 100917) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MT NP-100917) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2024-02-29 |