| NPI | 1972892073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2011005424) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2005027528) |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2026-07-11 |