| NPI | 1184285108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024177749) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001254242) |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2021-05-20 |