| NPI | 1003573551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5017401) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C013881) |
| 163W00000X Registered Nurse (Licence: NC 297482) | |
| Enumeration Date | 2021-11-19 |
| Last Update Date | 2023-01-05 |