| NPI | 1912379785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 6692 - 33) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 6692-33) |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2025-07-02 |