| NPI | 1851769350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2017003279) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017003279) |
| 363LF0000X Nurse Practitioner, Family (Licence: AR 221717) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AR 221717) | |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2023-04-18 |