| NPI | 1174759666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G105043) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 105043) |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2012-06-25 |