| NPI | 1710909932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11015647) |
| Additional Taxonomies | 174400000X Specialist (Licence: MA 172893) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2022-02-07 |