| NPI | 1114599214 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC GOOL-FO8WC) | 
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 2021028920) | 
| Enumeration Date | 2021-07-16 | 
| Last Update Date | 2021-07-31 |