| NPI | 1639930431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024191322) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001328246) |
| Enumeration Date | 2024-01-18 |
| Last Update Date | 2025-01-03 |