| NPI | 1629581517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AL 1-129482) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 1-129482) |
| 363L00000X Nurse Practitioner (Licence: AL 1-129482) | |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2019-02-14 |