| NPI | 1104569979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 27111) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MT RN-132253) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MT 195623) | |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2023-08-03 |