| NPI | 1962917864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R188158) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R188158) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R188158) | |
| Enumeration Date | 2017-12-13 |
| Last Update Date | 2021-05-21 |