| NPI | 1770706277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA UP005764L) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA UP005764L) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2009-10-08 |