| NPI | 1073943726 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NM 57404) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 609017) | 
| Enumeration Date | 2013-11-16 | 
| Last Update Date | 2020-02-12 |