| NPI | 1063255016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11036683) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9567915) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11036683) | |
| Enumeration Date | 2024-06-17 |
| Last Update Date | 2026-05-14 |