| NPI | 1063497915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71000888) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71000888A) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2010-07-29 |