| NPI | 1790387975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11010381) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F11200332) |
| 163W00000X Registered Nurse (Licence: FL RN9427323) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 2022096470) | |
| Enumeration Date | 2020-11-12 |
| Last Update Date | 2023-07-06 |