| NPI | 1760839617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11016626) |
| Additional Taxonomies | 251E00000X Home Health |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11016626) | |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2026-08-19 |