| NPI | 1972605202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 2021013806) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL APRN9290324) |
| 363L00000X Nurse Practitioner (Licence: FL 2018004992) | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2023-09-15 |