| NPI | 1619411279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11001264) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN 256580) |
| Enumeration Date | 2016-12-15 |
| Last Update Date | 2019-09-16 |