| NPI | 1962405662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024164157) |
| Additional Taxonomies | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: VA 0015000736) |
| 163W00000X Registered Nurse (Licence: VA 0001118504) | |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2007-07-08 |