| NPI | 1619358306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2019003633) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2010018982) |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2025-04-30 |