| NPI | 1720146772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VT 101.0136722) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 19126) |
| 163W00000X Registered Nurse (Licence: CA 647378) | |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2024-01-02 |