NPI | 1053973198 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 44093) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WY 44093) |
Enumeration Date | 2019-06-28 |
Last Update Date | 2021-06-14 |