| NPI | 1679052104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 8778) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 8778) |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2021-12-01 |