| NPI | 1174967319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 26583) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 174031) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2020-10-21 |