| NPI | 1609372168 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 2024091002) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11018968) | 
| Enumeration Date | 2018-04-03 | 
| Last Update Date | 2025-07-31 |