| NPI | 1104606482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA 61491307) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA 61491307) |
| Enumeration Date | 2023-10-03 |
| Last Update Date | 2025-02-22 |