| NPI | 1770119257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AL 1-143935) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1143935) |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2022-01-05 |