| NPI | 1174262091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 406244) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA N60853255) |
| 163W00000X Registered Nurse (Licence: NY 710054) | |
| Enumeration Date | 2022-05-31 |
| Last Update Date | 2024-09-26 |