| NPI | 1164725602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 16951-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 164094-030) |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2026-03-20 |