| NPI | 1124717418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 2025039988) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11026099) |
| Enumeration Date | 2023-05-03 |
| Last Update Date | 2025-10-09 |