| NPI | 1972510519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: DC RN1021578) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 9175075) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA 148821) | |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2011-11-29 |