| NPI | 1215039144 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71004078A) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 34004769A) | 
| 363L00000X Nurse Practitioner (Licence: IN 71004078A) | |
| Enumeration Date | 2006-09-01 | 
| Last Update Date | 2023-10-20 |