| NPI | 1962817528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 210482) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5007027) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 210482) | |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2022-01-12 |