| NPI | 1013564996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G156884) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A156218) |
| Enumeration Date | 2019-08-24 |
| Last Update Date | 2025-08-26 |