NPI | 1083203426 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN300337) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN300337) |
Enumeration Date | 2021-01-11 |
Last Update Date | 2024-09-08 |