| NPI | 1639635964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11001708) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F09181035) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11001708) | |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2023-05-03 |