| NPI | 1992415400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R216720) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R216720) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R216720) | |
| Enumeration Date | 2022-11-25 |
| Last Update Date | 2024-03-15 |