| NPI | 1104435791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G163173) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: IA 123811) |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2021-05-20 |