| NPI | 1255504742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024173736) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 210912) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5005835) | |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2022-01-20 |