| NPI | 1750523221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP 9334423) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9334423) |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2009-03-30 |
| Last Update Date | 2021-12-02 |