| NPI | 1750161626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024188277) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001251978) |
| 163W00000X Registered Nurse (Licence: PA RN666513) | |
| Enumeration Date | 2023-09-29 |
| Last Update Date | 2024-06-18 |