| NPI | 1790540177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA 00000000) |
| Additional Taxonomies | 163WP2201X Registered Nurse, Ambulatory Care (Licence: LA 116043) |
| Enumeration Date | 2024-02-15 |
| Last Update Date | 2024-02-15 |