| NPI | 1235773326 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 24318) | 
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 24318) | 
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: SC 211413) | |
| Enumeration Date | 2019-10-31 | 
| Last Update Date | 2025-05-20 |