| NPI | 1053065250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP030400) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA 12345678) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-02-07 |
| Last Update Date | 2025-08-18 |