NPI | 1053869875 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173965) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD AC004662) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024173965) | |
Enumeration Date | 2016-09-21 |
Last Update Date | 2024-10-23 |