| NPI | 1912428343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MT NUR-APRN-LIC-127957) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MT 72727) |
| 363L00000X Nurse Practitioner (Licence: MT NUR-APRN-LIC-127957) | |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2020-01-14 |