| NPI | 1922759570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R149910) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MD r149910) |
| Enumeration Date | 2022-01-14 |
| Last Update Date | 2024-02-15 |