| NPI | 1023582665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024177558) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R154907) |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2026-08-20 |