| NPI | 1629733860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2022042619) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MO 2012023885) |
| Enumeration Date | 2021-11-02 |
| Last Update Date | 2022-10-28 |