| NPI | 1114253317 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD F0816181) | 
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R200704) | 
| Enumeration Date | 2009-10-22 | 
| Last Update Date | 2023-03-24 |