| NPI | 1558706580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2016032505) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2007011717) |
| 363L00000X Nurse Practitioner (Licence: MO 2013042562) | |
| Enumeration Date | 2013-05-03 |
| Last Update Date | 2025-09-18 |