| NPI | 1184611139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NC 5000705) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NC 0050-00705) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2025-01-30 |