| NPI | 1043672504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 11218-33) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: LA RN148353) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: WI 198941-30) | |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2022-01-07 |