| NPI | 1083037477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2023012587) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014000683) |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2023-06-11 |