| NPI | 1952880791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AR A005809) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: AR A005809) |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2019-01-10 |