| NPI | 1962088559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2021023279) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2018002924) |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2022-08-26 |