| NPI | 1760151567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MT 177628) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MT NUR-APRN-LIC-177628) |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2024-06-20 |