| NPI | 1275221368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 13604) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 13604) |
| Enumeration Date | 2023-04-26 |
| Last Update Date | 2024-01-09 |