| NPI | 1972126142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024186591) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024186591) |
| 163WL0100X Registered Nurse, Lactation Consultant (Licence: VA L-88133) | |
| Enumeration Date | 2020-05-22 |
| Last Update Date | 2025-09-18 |