| NPI | 1962763912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD 2022009733) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R190030) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2023-11-02 |