| NPI | 1174308399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 2024005728) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 237326) |
| Enumeration Date | 2023-08-28 |
| Last Update Date | 2025-01-11 |