| NPI | 1104350701 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 229495)  | 
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61411051)  | 
| Enumeration Date | 2017-04-20 | 
| Last Update Date | 2024-05-16 |