| NPI | 1326680596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5012939) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 299062) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD AC003827) | |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2021-08-04 |