NPI | 1003113739 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R151970) |
Additional Taxonomies | 364SP0807X Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent (Licence: MD R151970) |
Enumeration Date | 2011-02-15 |
Last Update Date | 2023-02-14 |