| NPI | 1912485822 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 9387515)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9387515)  | 
| Enumeration Date | 2018-08-02 | 
| Last Update Date | 2024-10-04 |