| NPI | 1053065250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP030400) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA 12345678) | |
| Enumeration Date | 2022-02-07 |
| Last Update Date | 2024-09-13 |