| NPI | 1972909067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO 0993869) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CO 86216) |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2023-03-05 |