| NPI | 1720714215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024191812) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD T500-622-027-288) |
| Enumeration Date | 2022-07-27 |
| Last Update Date | 2024-12-30 |