| NPI | 1902102536 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11017867) | 
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: FL PN1282021) | 
| 363L00000X Nurse Practitioner (Licence: FL APRN11017867) | |
| Enumeration Date | 2011-01-29 | 
| Last Update Date | 2024-02-22 |