| NPI | 1962154690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2022015591) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2017034814) |
| Enumeration Date | 2022-01-24 |
| Last Update Date | 2022-12-30 |