| NPI | 1104566181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R141803) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R141803) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: DC RN67556) | |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2024-03-25 |