| NPI | 1265064059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL F09220784) |
| Additional Taxonomies | 104100000X Social Worker (Licence: FL CBHCMS100910) |
| 163W00000X Registered Nurse (Licence: FL 9554888) | |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2022-10-04 |