| NPI | 1912966383 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R075592)  | 
| Additional Taxonomies | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: MD R075592)  | 
| Enumeration Date | 2006-03-22 | 
| Last Update Date | 2015-03-12 |