| NPI | 1548401706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD 2012005172) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD 2008011658) |
| 163W00000X Registered Nurse (Licence: MN R-153536-7) | |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2014-11-25 |