| NPI | 1790540631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: FL 11033263) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9426818) |
| Enumeration Date | 2024-02-20 |
| Last Update Date | 2024-08-23 |