| NPI | 1770954398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID 56903) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9325608) |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2025-07-22 |