| NPI | 1699395186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5016153) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-174347) |
| 363L00000X Nurse Practitioner (Licence: NC 5016153) | |
| Enumeration Date | 2020-04-24 |
| Last Update Date | 2023-03-24 |