| NPI | 1811668619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MT NUR-APRN-LIC-178908) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MT NUR-RN-LIC-39510) |
| Enumeration Date | 2021-09-22 |
| Last Update Date | 2021-12-08 |