| NPI | 1063471134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R197967) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024166119) |
| Enumeration Date | 2006-03-18 |
| Last Update Date | 2013-01-28 |