| NPI | 1376000570 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024180549)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5011508)  | 
| Enumeration Date | 2019-02-23 | 
| Last Update Date | 2024-06-14 |