| NPI | 1992074652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5005422) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 227627) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5005422) | |
| Enumeration Date | 2011-12-23 |
| Last Update Date | 2020-10-23 |