| NPI | 1336691062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 7349) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 7439) |
| Enumeration Date | 2016-10-28 |
| Last Update Date | 2024-05-13 |