| NPI | 1528602497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11015659) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9350787) |
| Enumeration Date | 2019-11-04 |
| Last Update Date | 2021-10-19 |