| NPI | 1972215382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 2022009320) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5017490) |
| 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: VA 0024185817) | |
| Enumeration Date | 2022-12-16 |
| Last Update Date | 2024-07-18 |