| NPI | 1912398587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9274414) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 9274414) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 9274414) | |
| Enumeration Date | 2015-02-18 |
| Last Update Date | 2021-03-03 |