| NPI | 1376178905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 1376178905) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11006436) |
| Enumeration Date | 2020-03-04 |
| Last Update Date | 2022-06-06 |