| NPI | 1992109805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R178339) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R178339) |
| 163W00000X Registered Nurse (Licence: MD R178339) | |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2021-12-20 |