| NPI | 1790424794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95022269) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 825517) |
| 163W00000X Registered Nurse (Licence: CT 172978) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 2366453) | |
| Enumeration Date | 2022-05-31 |
| Last Update Date | 2025-05-22 |