| NPI | 1225468325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 4359-33) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 4359-33) |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2014-10-29 |