| NPI | 1295325223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA 61143335) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 66454) |
| Enumeration Date | 2021-01-23 |
| Last Update Date | 2021-12-01 |