| NPI | 1164021978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: VA 0024189450) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001260283) |
| 363L00000X Nurse Practitioner (Licence: VA 0024189450) | |
| Enumeration Date | 2020-10-22 |
| Last Update Date | 2024-07-01 |