| NPI | 1114654340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID 77648) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID 77648) |
| 163WL0100X Registered Nurse, Lactation Consultant (Licence: ID L-302839) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MT NUR-APRN-LIC-179716) | |
| Enumeration Date | 2022-08-08 |
| Last Update Date | 2024-08-22 |