| NPI | 1306289459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 13744-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 201017-30) |
| 164W00000X Licensed Practical Nurse (Licence: WI 308127-31) | |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2023-03-21 |