| NPI | 1790661320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: UT 6218966-4405) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: UT 62188966-8900) |
| Enumeration Date | 2025-08-11 |
| Last Update Date | 2025-08-11 |