| NPI | 1366824468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2020009549) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015011479) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2024-11-15 |