| NPI | 1639627110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 60996-30) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 7252) |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2020-03-06 |