| NPI | 1942642426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: IA G121438) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 5382) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CT 005382) | |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2021-05-20 |