| NPI | 1063030369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 30045) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 227419) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NM 78827) | |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2024-05-24 |