| NPI | 1083688295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 3433-33) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: WI 131460-030) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2011-12-13 |