| NPI | 1053384537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 19708) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 0050-01561) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2018-02-03 |