| NPI | 1336805290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA 137733) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-11-15 |
| Last Update Date | 2026-04-06 |