| NPI | 1114515830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD 230486) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DC NP1046784) |
| Enumeration Date | 2021-01-07 |
| Last Update Date | 2026-04-20 |