| NPI | 1053876573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2019004291) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: KS 14-133740-051) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MO 2009026463) | |
| Enumeration Date | 2019-02-08 |
| Last Update Date | 2019-02-08 |