| NPI | 1578193637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MO 2020001756) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: AR 219140) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: KS 53-82623-061) | |
| Enumeration Date | 2020-01-16 |
| Last Update Date | 2024-04-09 |