| NPI | 1871122556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 2024001821) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 1002033) |
| Enumeration Date | 2020-04-05 |
| Last Update Date | 2024-07-16 |