| NPI | 1629494711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MO 2022029286) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2014003277) |
| Enumeration Date | 2014-03-13 |
| Last Update Date | 2022-07-28 |