| NPI | 1174945067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2024001836) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014000699) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2014000699) | |
| Enumeration Date | 2014-01-10 |
| Last Update Date | 2024-02-16 |