| NPI | 1124676622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL aprn11001875) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11001875) |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2024-10-18 |