| NPI | 1053700500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MD R204731) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: DC NP) |
| Enumeration Date | 2015-01-21 |
| Last Update Date | 2023-10-09 |