| NPI | 1912282674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 180906) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 180906) |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2022-10-05 |