| NPI | 1689211609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2020027127) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2006015479) |
| Enumeration Date | 2019-12-09 |
| Last Update Date | 2026-09-16 |