| NPI | 1629611686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024178104) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024178104) |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2022-11-15 |