| NPI | 1265906200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2019002644) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2014024179) |
| Enumeration Date | 2019-01-13 |
| Last Update Date | 2023-12-04 |