| NPI | 1134111057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NC 5000964) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NC 5000964) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: SC 4181) | |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2019-11-15 |