| NPI | 1497072391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 15869) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: WI 16156030) |
| Enumeration Date | 2010-05-01 |
| Last Update Date | 2025-02-25 |