| NPI | 1629561584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD 2022067063) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R212770) |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2025-10-26 |