| NPI | 1770150484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID ID-58820) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: ID ID-58820) |
| Enumeration Date | 2021-06-10 |
| Last Update Date | 2021-10-05 |