| NPI | 1902505589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2023026329) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2021005828) |
| Enumeration Date | 2023-03-02 |
| Last Update Date | 2023-07-11 |