| NPI | 1407515547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 11679-33) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 11679-33) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-12-16 |
| Last Update Date | 2024-04-09 |