| NPI | 1699386367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 10241) |
| Additional Taxonomies | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: WI 236244-30) |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2024-05-29 |