| NPI | 1982590287 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95037620) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR26140300) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NY 820234-01) | |
| 163W00000X Registered Nurse (Licence: DE L1-0073853) | |
| 163W00000X Registered Nurse (Licence: CA RN95333845) | |
| 163W00000X Registered Nurse (Licence: PA RN788149) | |
| Enumeration Date | 2025-06-16 |
| Last Update Date | 2025-12-01 |