| NPI | 1447627559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 9440284) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2263047) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2017-05-10 |