| NPI | 1205425386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11007975) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 11007975) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11007975) | |
| Enumeration Date | 2021-01-13 |
| Last Update Date | 2022-03-12 |