| NPI | 1194950204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 13738) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 151058-30) |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2024-03-07 |