| NPI | 1972841856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MD R140642) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R140642) |
| 363LF0000X Nurse Practitioner Family (Licence: MD R140642) | |
| Enumeration Date | 2013-01-28 |
| Last Update Date | 2022-04-01 |