| NPI | 1548000680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024190665) |
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: VA 0001234491) |
| Enumeration Date | 2024-05-28 |
| Last Update Date | 2024-08-19 |