| NPI | 1184072241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 7604481-8900) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 7604481-3102) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2016-09-22 |