| NPI | 1063908242 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11009252) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024176301) | 
| Enumeration Date | 2018-07-10 | 
| Last Update Date | 2023-08-02 |