| NPI | 1124836036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: LA RN137478) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA 242632) |
| Enumeration Date | 2024-12-23 |
| Last Update Date | 2025-09-11 |