| NPI | 1649894080 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024179686) | 
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: VA 0024179686) | 
| Enumeration Date | 2020-06-02 | 
| Last Update Date | 2025-08-20 |