| NPI | 1104591098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024182387) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: VA 0001191786) |
| Enumeration Date | 2021-08-12 |
| Last Update Date | 2023-11-29 |