| NPI | 1073963773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 6957-33) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 6957) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2019-01-10 |