| NPI | 1154791507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024186971) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001323812) |
| Enumeration Date | 2015-09-28 |
| Last Update Date | 2023-09-19 |