| NPI | 1114505161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 1103694) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 944776) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 1103694) | |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2025-08-27 |