| NPI | 1932523552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G136109) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: IA 136109) |
| Enumeration Date | 2014-02-18 |
| Last Update Date | 2020-03-20 |