| NPI | 1104073428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: IA G110925) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IA A-110925) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2023-01-19 |