| NPI | 1164852893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5006598) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 190216) |
| Enumeration Date | 2013-11-15 |
| Last Update Date | 2013-11-15 |