| NPI | 1164134862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11023577) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9320243) |
| Enumeration Date | 2022-12-14 |
| Last Update Date | 2024-07-24 |