| NPI | 1306076112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024165430) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WY 30348.1159) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2014-08-15 |