| NPI | 1205540804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11030990) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 905733) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1145290) | |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2024-06-03 |