| NPI | 1982142253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MO 2020039518) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 150688) |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2021-04-07 |