| NPI | 1285081695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID 54425) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID N-39732) |
| 163W00000X Registered Nurse (Licence: OR 10012906) | |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2023-11-03 |