| NPI | 1639425499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 5057) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 134469) |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2025-04-08 |