| NPI | 1205599354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5016202) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 228097) |
| Enumeration Date | 2021-10-15 |
| Last Update Date | 2024-05-16 |