| NPI | 1730804592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 1319433) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 9654) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G170115) | |
| Enumeration Date | 2022-10-04 |
| Last Update Date | 2022-12-01 |