| NPI | 1851953699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024177518) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0021477518) |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2023-11-08 |