| NPI | 1417218199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD 00000000) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DC RN1016287) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R174843) | |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2021-07-23 |