| NPI | 1962393835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11040767) |
| Additional Taxonomies | 163WI0500X Registered Nurse, Infusion Therapy (Licence: FL 9548570) |
| Enumeration Date | 2025-07-10 |
| Last Update Date | 2025-07-10 |