| NPI | 1467139667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11035892) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9604300) |
| 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: FL RN9604300) | |
| Enumeration Date | 2023-06-29 |
| Last Update Date | 2024-10-16 |