| NPI | 1326521543 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 28201) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 0000Intern) | 
| Enumeration Date | 2018-09-13 | 
| Last Update Date | 2025-04-15 |