| NPI | 1821730193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 11873) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 11873) |
| 363L00000X Nurse Practitioner (Licence: WI 163519) | |
| Enumeration Date | 2022-04-08 |
| Last Update Date | 2022-10-26 |