| NPI | 1720457427 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 7666569-4405) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 7666569-3102) | 
| Enumeration Date | 2015-09-23 | 
| Last Update Date | 2025-10-16 |