| NPI | 1972163210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11003096) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11003096) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11003096) | |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2024-07-22 |