NPI | 1083012850 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AL 1-107285) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-107285) |
Enumeration Date | 2014-12-10 |
Last Update Date | 2021-04-21 |