| NPI | 1710522016 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11004480) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 11004480) | 
| Enumeration Date | 2019-11-10 | 
| Last Update Date | 2025-04-09 |