| NPI | 1003163460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 6067-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 190291-30) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 6067-33) | |
| Enumeration Date | 2012-08-04 |
| Last Update Date | 2021-06-29 |