| NPI | 1093524001 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA 61649666) | 
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA 61649666) | 
| Enumeration Date | 2025-01-03 | 
| Last Update Date | 2025-04-15 |