| NPI | 1265036537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5013887) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 260169) |
| Enumeration Date | 2020-11-26 |
| Last Update Date | 2021-01-26 |