| NPI | 1972993574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5007450) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5007450) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5007450) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5007450) | |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2020-06-23 |