| NPI | 1104606144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 27970) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC APN.27970) |
| Enumeration Date | 2023-10-05 |
| Last Update Date | 2024-05-20 |