| NPI | 1740677210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11012677) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71005432A) |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71005432A) | |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2021-05-20 |