| NPI | 1407363880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: LA AP07548) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: LA AP07548) |
| Enumeration Date | 2018-01-07 |
| Last Update Date | 2018-07-04 |