| NPI | 1720862998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 15809) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP61467880) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61467880) | |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2024-08-28 |