| NPI | 1740931294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA 275229) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA 275229) |
| 163W00000X Registered Nurse (Licence: GA 275229) | |
| Enumeration Date | 2022-01-17 |
| Last Update Date | 2023-10-12 |