| NPI | 1942742465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 20557) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5010957) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 20557) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5010957) | |
| Enumeration Date | 2016-11-15 |
| Last Update Date | 2021-11-01 |