| NPI | 1245274240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SD 1052055) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 0485) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2025-09-11 |