| NPI | 1790062420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA NP288930) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA NP288930) |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2026-03-12 |