| NPI | 1982205225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MT 192050) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MT 39511) |
| 163WW0000X Registered Nurse, Wound Care (Licence: MT 39511) | |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2022-02-01 |