| NPI | 1811052319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 6437) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 6437) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 1999139490) | |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2024-08-28 |