| NPI | 1942663794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 9515-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 176081-30) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 9515-33) | |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2021-08-24 |