| NPI | 1992218986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN225970) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: GA RN225970) |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2019-04-12 |