| NPI | 1487149092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 9356194) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9356194) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 15282) | |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2025-08-27 |