| NPI | 1043933740 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 114351)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 114351)  | 
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NE 114351)  | |
| Enumeration Date | 2022-09-19 | 
| Last Update Date | 2023-08-16 |