| NPI | 1659367944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 281130) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VT 1010023085) |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2019-08-13 |