| NPI | 1912585787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11012451) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11012451) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95021018) | |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2022-05-23 |