| NPI | 1770304768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MT NUR-APRN-LIC-242602) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MT NUR-APRN-LIC-242602) |
| Enumeration Date | 2024-10-22 |
| Last Update Date | 2025-07-28 |