| NPI | 1487169165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2018002781) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 77964) |
| Enumeration Date | 2017-12-04 |
| Last Update Date | 2022-07-13 |