| NPI | 1164650420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 191449) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 200950062NP) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AK 1323) | |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2012-11-28 |