| NPI | 1053313536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2006023930) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NE 110512) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 200842) | |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2011-07-27 |