| NPI | 1164935896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024175684) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA AG11170050) |
| Enumeration Date | 2017-11-16 |
| Last Update Date | 2022-11-21 |