| NPI | 1669216925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024190678) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001186871) |
| Enumeration Date | 2024-06-21 |
| Last Update Date | 2024-07-12 |