| NPI | 1376098731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN217424) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN217424) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: GA RN217424) | |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2017-02-18 |