| NPI | 1124765680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R118954) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R118954) |
| Enumeration Date | 2022-05-17 |
| Last Update Date | 2025-09-30 |