NPI | 1073269825 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11011489) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11011489) |
363LF0000X Nurse Practitioner, Family (Licence: FL APRN11011489) | |
Enumeration Date | 2022-03-01 |
Last Update Date | 2024-07-15 |