| NPI | 1639640063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024177037) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: VA 0024177037) |
| Enumeration Date | 2018-12-11 |
| Last Update Date | 2022-11-17 |