| NPI | 1811024219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NC 5001313) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 152520) |
| 363LF0000X Nurse Practitioner Family (Licence: NC 5001313) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2023-03-01 |