| NPI | 1972760684 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11008246)  | 
| Additional Taxonomies | 171WH0202X Contractor, Home Modifications | 
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2008-05-20 | 
| Last Update Date | 2022-01-26 |