| NPI | 1790189272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2023048915) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014036363) |
| Enumeration Date | 2014-10-13 |
| Last Update Date | 2024-10-09 |