| NPI | 1700215753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2022004859) |
| Additional Taxonomies | 283X00000X Rehabilitation Hospital (Licence: MO 2012017522) |
| Enumeration Date | 2013-11-09 |
| Last Update Date | 2022-02-15 |