| NPI | 1124519822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2018024368) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 138149) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 10504) | |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2020-11-03 |