| NPI | 1669292017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024191515) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0001323410) |
| Enumeration Date | 2024-10-11 |
| Last Update Date | 2024-11-11 |