| NPI | 1437212891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 0199854) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 2329-033) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2015-05-15 |