| NPI | 1659478899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G 052035) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA 77622) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2011-03-23 |