| NPI | 1174154926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11005943) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9441637) |
| Enumeration Date | 2020-01-30 |
| Last Update Date | 2021-08-24 |