| NPI | 1013748052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 15484) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 15484-33) |
| 363L00000X Nurse Practitioner (Licence: WI 15484) | |
| Enumeration Date | 2024-08-12 |
| Last Update Date | 2024-11-04 |