| NPI | 1609143684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AL 1-135170) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: AL 5742) |
| Enumeration Date | 2011-11-19 |
| Last Update Date | 2025-09-08 |