| NPI | 1639875263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 13546) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 169750-30) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 169750-30) | |
| Enumeration Date | 2023-02-06 |
| Last Update Date | 2023-03-20 |