| NPI | 1699755314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 201440) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 201440035826122) |
| 363L00000X Nurse Practitioner (Licence: NC 017226502) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2013-06-06 |