| NPI | 1821301912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA APO6191) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA AP06191) |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2021-06-02 |