| NPI | 1730561119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP015110) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: PA rn623507) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2016-07-05 |