| NPI | 1285701979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 836) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 836-033) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 836) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2014-04-17 |