NPI | 1053105585 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MT NUR-APRN-LIC-266513) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MT 177667) |
Enumeration Date | 2025-04-08 |
Last Update Date | 2025-08-05 |