| NPI | 1124219100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2020034241) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MO 2004020809) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2022-09-12 |