| NPI | 1124647722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024180449) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R164320) |
| Enumeration Date | 2020-04-13 |
| Last Update Date | 2023-11-14 |