| NPI | 1003709254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 2025029048) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 354748) |
| Enumeration Date | 2025-05-29 |
| Last Update Date | 2025-05-29 |