| NPI | 1205124310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA AP06289) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA APO6289) |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2021-05-07 |