| NPI | 1376702175 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ND R28166) | 
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ND R28166) | 
| Enumeration Date | 2008-06-05 | 
| Last Update Date | 2019-10-10 |