| NPI | 1023661741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11007897) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN3354992) |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2021-03-18 |