| NPI | 1770672495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2020005456) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MO 046630) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2024-01-08 |