| NPI | 1962055061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: NC 5012036) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NC 5012036) |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2024-03-28 |