| NPI | 1205291572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 16452-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 198776-30) |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2025-02-07 |