| NPI | 1912656414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA 121700) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IA 1202571) |
| Enumeration Date | 2022-03-22 |
| Last Update Date | 2023-09-12 |