| NPI | 1598012619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 5086) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 5086) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 10640) | |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2023-10-23 |