| NPI | 1659842169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 16871) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 221847) |
| 363L00000X Nurse Practitioner (Licence: WI 16871) | |
| Enumeration Date | 2018-12-09 |
| Last Update Date | 2025-09-30 |