| NPI | 1285109678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2025037770) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN222785) |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2025-09-24 |