| NPI | 1972853349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NM CNP-01975) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NM CNP-01975) |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2023-05-19 |