| NPI | 1710596358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11009200) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9365294) |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2021-06-30 |