| NPI | 1992220263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 28724) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: SC 241405) |
| 163W00000X Registered Nurse (Licence: SC 241405) | |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2024-07-01 |