NPI | 1073021630 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11009072) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9300927) |
Enumeration Date | 2018-01-17 |
Last Update Date | 2020-09-11 |