| NPI | 1992359889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024195915) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001264302) |
| Enumeration Date | 2019-07-29 |
| Last Update Date | 2026-03-05 |