| NPI | 1013245745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5006893) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 206943) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 206943) | |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2022-12-15 |