| NPI | 1912552027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA 2083141) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA 2019044689) |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2019-12-16 |