| NPI | 1063924405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024175587) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001204274) |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2023-05-30 |