NPI | 1003404534 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3016004) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: KY 3016004) |
Enumeration Date | 2021-01-10 |
Last Update Date | 2024-04-22 |