| NPI | 1336401538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 9187742) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 9187742) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 9187742) | |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2023-11-08 |