| NPI | 1700806262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: IA 053998) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA Z-053998) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA Z-053998) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2007-07-08 |