| NPI | 1790378545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11011661) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9406430) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11011661) | |
| Enumeration Date | 2021-02-12 |
| Last Update Date | 2024-01-29 |