| NPI | 1265016596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G166725) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: IA 145402) |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2025-08-18 |