| NPI | 1639198302 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: RI RN27310) |
| Additional Taxonomies | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: RI PPNS00074) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2012-03-13 |