| NPI | 1821547027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024174047) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174047) |
| Enumeration Date | 2016-09-28 |
| Last Update Date | 2022-03-29 |