| NPI | 1962169805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN315074) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 225792) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC APN.26021) | |
| Enumeration Date | 2021-11-28 |
| Last Update Date | 2024-01-09 |