| NPI | 1205072535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 3591-033) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 3591) |
| Enumeration Date | 2008-12-16 |
| Last Update Date | 2020-03-04 |