| NPI | 1154908036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11019931) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 299772) |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2022-06-22 |