| NPI | 1740032895 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 28454) | 
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 28454) | 
| Enumeration Date | 2024-04-02 | 
| Last Update Date | 2024-05-10 |