| NPI | 1073021630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: FL 11009072) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9300927) |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2020-09-11 |