| NPI | 1295999480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 10956-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 122519-030) |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2021-05-24 |