| NPI | 1205289469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: FL APRN11005752) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95024404) |
| 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: FL RN9376191) | |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2020-01-14 |