| NPI | 1104470038 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11003519) | 
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5019367) | 
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11003519) | |
| Enumeration Date | 2019-07-29 | 
| Last Update Date | 2025-08-21 |