| NPI | 1063990356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2023016196) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2018007967) |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2023-06-28 |