| NPI | 1912248956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: AL 1-121164) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AL 1-121164) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: AL 1-121164) | |
| Enumeration Date | 2013-03-14 |
| Last Update Date | 2024-04-28 |