| NPI | 1104579887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11017922) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F02220061) |
| Enumeration Date | 2022-02-01 |
| Last Update Date | 2024-07-02 |