| NPI | 1194221200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2021036669) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017036480) |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2023-06-29 |