NPI | 1023555638 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G075234) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NE 113003) |
Enumeration Date | 2017-01-22 |
Last Update Date | 2021-06-14 |