| 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 |