| NPI | 1275013112 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NE 112706)  | 
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: NE 51393)  | 
| Enumeration Date | 2018-08-20 | 
| Last Update Date | 2022-03-28 |