| NPI | 1417758723 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 9412111-4405) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 9412111-4405) | 
| Enumeration Date | 2025-03-22 | 
| Last Update Date | 2025-10-30 |