| NPI | 1407499783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024178532) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001228374) |
| Enumeration Date | 2019-10-19 |
| Last Update Date | 2025-09-29 |