| NPI | 1740801588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61327117) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2020-05-04 |
| Last Update Date | 2022-07-25 |