| NPI | 1053879866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024187517) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK R0105952) |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2023-07-11 |