| NPI | 1356642672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID 75282) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 75282) |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP60194889) | |
| Enumeration Date | 2010-11-03 |
| Last Update Date | 2023-11-01 |