| NPI | 1255604039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA 226968) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA 110111) |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2022-08-15 |