| NPI | 1164066767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AL 1-142623) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-142623) |
| Enumeration Date | 2019-11-06 |
| Last Update Date | 2023-06-30 |