| NPI | 1972974400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: LA 300215) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 300215) |
| 363AM0700X Physician Assistant, Medical (Licence: LA 300215) | |
| Enumeration Date | 2015-10-09 |
| Last Update Date | 2025-11-04 |