| NPI | 1013264761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP 60337127) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN273882) |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2019-10-14 |