| NPI | 1104357938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R144632) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DC RN960708) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2023-05-31 |