| NPI | 1982399556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024187026) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001312747) |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2023-05-03 |