| NPI | 1972012193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2023048920) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2023048920) |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2025-02-11 |