NPI | 1073924122 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9206748) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 9206748) |
Enumeration Date | 2014-05-12 |
Last Update Date | 2022-12-07 |