| NPI | 1962963389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MD R200367) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD R200367) |
| 363LF0000X Nurse Practitioner Family (Licence: MD R200367) | |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2023-11-27 |