| NPI | 1902192610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2353890) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 2367) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SD CP001334) | |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2025-02-03 |