| NPI | 1972068757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5011600) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 289876) |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2022-09-09 |