| NPI | 1972812097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G-122860) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA G122860) |
| Enumeration Date | 2010-10-07 |
| Last Update Date | 2022-09-16 |