| NPI | 1962930826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA 61324878) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 902067) |
| 363LF0000X Nurse Practitioner, Family (Licence: MS 902067) | |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2022-08-02 |