| NPI | 1194358085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 9412161-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 9412161-3102) |
| Enumeration Date | 2020-02-19 |
| Last Update Date | 2023-05-13 |