| NPI | 1205897337 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G-052117)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 052117)  | 
| Enumeration Date | 2006-03-29 | 
| Last Update Date | 2012-04-26 |