| NPI | 1336478601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2010013176) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2010013176) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2010013176) | |
| Enumeration Date | 2009-12-16 |
| Last Update Date | 2023-02-03 |