| NPI | 1316945447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WY 8418.0101) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 53595) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: WY 0101) | |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2017-07-05 |