| NPI | 1780641944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: VA 0024058939) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: VA 0001058939) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2016-03-24 |