| NPI | 1609414135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11005305) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11005305) |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2025-07-02 |