| NPI | 1194484477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R194786) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R194786) |
| Enumeration Date | 2021-12-14 |
| Last Update Date | 2026-03-19 |