| NPI | 1174225098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 27077) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5019459) |
| Enumeration Date | 2023-03-22 |
| Last Update Date | 2024-09-09 |