| NPI | 1629021597 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 364SP0810X Clinical Nurse Specialist, Psych/Mental Health, Child & Family (Licence: MO 1999140595) | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 1999140595) | 
| Enumeration Date | 2006-05-19 | 
| Last Update Date | 2023-01-18 |