| NPI | 1336151612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MT 101000) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MT 101000) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2024-04-05 |