| NPI | 1407044134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NE 105079) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NE 316) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NE 105079) | |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2008-11-20 |