| NPI | 1770990228 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2018004929) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 20147025547) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2019-01-31 |