| NPI | 1952415085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: WI 8103-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WI 8103) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MN R1306952) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2021-03-30 |