| NPI | 1609254630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA APO7511) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: LA AP07511) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2026-05-15 |