NPI | 1043547748 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R875890) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11002464) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11002464) | |
Enumeration Date | 2009-11-17 |
Last Update Date | 2021-04-26 |