| NPI | 1104470038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11003519) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11003519) |
| Enumeration Date | 2019-07-29 |
| Last Update Date | 2021-01-12 |