| NPI | 1215280516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R224538) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: DC 62407) |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2024-04-23 |