| NPI | 1790207009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: VA 0001136743) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001136743) |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2022-07-21 |