| NPI | 1225143399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 1497) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 105002-030) |
| 363L00000X Nurse Practitioner (Licence: WI 1497-033) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2018-08-29 |