| NPI | 1164759742 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL ARNP9346569) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN263331) | 
| 363LF0000X Nurse Practitioner, Family (Licence: CA 19041) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP 9346569) | |
| 363L00000X Nurse Practitioner (Licence: CA 19041) | |
| Enumeration Date | 2009-11-03 | 
| Last Update Date | 2025-10-06 |