| NPI | 1619054459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA 2009008422) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN117919) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA 0364455) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2018-11-14 |