| NPI | 1891402350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2022035981) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 53-81591-091) |
| Enumeration Date | 2022-11-03 |
| Last Update Date | 2025-01-17 |