| NPI | 1043828965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024184801) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN0000214389) |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2024-04-23 |