| NPI | 1275174807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 2025004842) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC AG04190024) |
| Enumeration Date | 2019-10-04 |
| Last Update Date | 2025-07-09 |