| NPI | 1164067476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD AC005842) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MD R185002) |
| Enumeration Date | 2019-11-11 |
| Last Update Date | 2023-09-18 |