| NPI | 1366113979 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G181731)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A165769)  | 
| Enumeration Date | 2021-09-23 | 
| Last Update Date | 2024-12-14 |