| NPI | 1487249454 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5016761)  | 
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5016761)  | 
| Enumeration Date | 2021-03-02 | 
| Last Update Date | 2024-07-15 |