| NPI | 1104436526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R193138) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD 193138) |
| Enumeration Date | 2020-08-01 |
| Last Update Date | 2022-08-29 |