| NPI | 1417657107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11025705) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9457938) |
| Enumeration Date | 2023-03-09 |
| Last Update Date | 2023-09-05 |