| NPI | 1609559129 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 30024)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 255646)  | 
| Enumeration Date | 2023-08-10 | 
| Last Update Date | 2025-04-22 |