| NPI | 1265047245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61083553) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1007948) |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2023-10-04 |