| NPI | 1710485511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 9363347) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 9363347) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178298) | |
| Enumeration Date | 2018-01-26 |
| Last Update Date | 2024-10-16 |