| NPI | 1649744681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: PA SP030669) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: PA SP019921) |
| Enumeration Date | 2019-01-13 |
| Last Update Date | 2024-11-01 |