| NPI | 1619016730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0807X Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent (Licence: TN APN15862) |
| Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: CT 002317) |
| 363L00000X Nurse Practitioner (Licence: CT 002317) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2012-09-17 |