| NPI | 1114599214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC GOOL-FO8WC) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 2021028920) |
| Enumeration Date | 2021-07-16 |
| Last Update Date | 2021-07-31 |