| NPI | 1104362912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AL 1-144793) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-144793) |
| Enumeration Date | 2017-01-18 |
| Last Update Date | 2022-11-11 |