| NPI | 1376028316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MS 902860) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS 881773) |
| 363L00000X Nurse Practitioner (Licence: MS 902860) | |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2018-09-25 |