| NPI | 1205377140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN9336570) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9336570) |
| Enumeration Date | 2017-03-11 |
| Last Update Date | 2023-10-06 |