| NPI | 1164977443 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9369140) | 
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN9369140) | 
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NM 62207) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F404634-01) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NM 62207) | |
| Enumeration Date | 2016-08-16 | 
| Last Update Date | 2025-07-31 |