| NPI | 1689912958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 9417766) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 171549) |
| 363L00000X Nurse Practitioner (Licence: TN 17517) | |
| Enumeration Date | 2013-01-22 |
| Last Update Date | 2015-12-18 |