| NPI | 1134720139 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61124644)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP61124644)  | 
| Enumeration Date | 2020-11-05 | 
| Last Update Date | 2024-02-09 |