| NPI | 1194392290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: VA 0024181586) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 0001265365) |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2025-04-15 |