| NPI | 1770735136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 9406716) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NM R41453) |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2022-06-08 |