| NPI | 1174958193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 5420) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 5420-33) |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2023-10-13 |