| NPI | 1699592170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2024048700) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 2024048700) |
| Enumeration Date | 2024-09-25 |
| Last Update Date | 2025-02-14 |