| NPI | 1003395559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5010822) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5010822) |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2018-08-07 |