| NPI | 1730781857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R196150) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024181070) |
| Enumeration Date | 2020-11-13 |
| Last Update Date | 2023-05-03 |