| NPI | 1073194452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11026044) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-160140) |
| Enumeration Date | 2021-04-18 |
| Last Update Date | 2023-05-03 |