| NPI | 1740828763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AL 2021027960) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-153392) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AL 1-153392) | |
| Enumeration Date | 2019-12-20 |
| Last Update Date | 2021-09-16 |