| NPI | 1982975074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP7745) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 806423) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 22229) | |
| Enumeration Date | 2012-01-20 |
| Last Update Date | 2016-12-08 |