| NPI | 1093127250 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA 236011) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA 236011) | 
| Enumeration Date | 2014-05-22 | 
| Last Update Date | 2021-11-02 |