| NPI | 1205210788 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024172748) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172748) | 
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD AC006692) | |
| Enumeration Date | 2015-07-15 | 
| Last Update Date | 2024-08-07 |