| NPI | 1104701366 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10050055)  | 
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL APRN11040949)  | 
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11040949)  | |
| Enumeration Date | 2025-08-07 | 
| Last Update Date | 2025-09-17 |