| NPI | 1700215506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 11926-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 176125-030) |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2026-02-05 |