| NPI | 1235753674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11007375) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9438488) |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2020-10-23 |