| NPI | 1518274109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: WI 65445-30) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: WI 1197-125) |
| 1041C0700X Social Worker Clinical (Licence: WI 3720-123) | |
| Enumeration Date | 2010-09-03 |
| Last Update Date | 2010-09-03 |