| NPI | 1760896815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024171762) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0001178199) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2023-04-05 |