| NPI | 1073289369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2026000551) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2020020976) |
| Enumeration Date | 2021-08-18 |
| Last Update Date | 2026-01-09 |