| NPI | 1669843876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 6480-33) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 6480) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 6480) | |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2016-10-10 |