| NPI | 1104468636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11002344) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11002344) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11002344) | |
| Enumeration Date | 2019-10-16 |
| Last Update Date | 2021-09-15 |