| NPI | 1194000620 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 23347) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP017163) | 
| 363L00000X Nurse Practitioner (Licence: CT 4840) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 23347) | |
| Enumeration Date | 2011-10-16 | 
| Last Update Date | 2025-07-09 |