| NPI | 1669874590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 6512) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 6038-33) |
| 363L00000X Nurse Practitioner (Licence: WI 6038) | |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2023-05-30 |