| NPI | 1619521747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NC 5012068) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 272154) |
| 363LF0000X Nurse Practitioner Family (Licence: NC 272154) | |
| Enumeration Date | 2019-07-26 |
| Last Update Date | 2025-08-05 |