| NPI | 1790126670 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R162214)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R162214)  | 
| Enumeration Date | 2013-07-08 | 
| Last Update Date | 2025-05-13 |