| NPI | 1558557108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 128051) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 3197-33) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2017-01-23 |