| NPI | 1205393089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2020038848) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019006658) |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2021-01-15 |