| NPI | 1699022129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 4933-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 155316-30) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2016-03-16 |