| NPI | 1972831493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024168543) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001134686) |
| Enumeration Date | 2009-11-20 |
| Last Update Date | 2009-11-20 |