| NPI | 1053799551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL PA9108699) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9108699) |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2025-10-01 |