| NPI | 1104275148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 23247) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 219948) |
| 363L00000X Nurse Practitioner (Licence: SC 23247) | |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2021-05-03 |