| NPI | 1053636068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 4027-033) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 145338-30) |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2022-07-21 |