NPI | 1083214753 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5019155) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 354720) |
Enumeration Date | 2020-10-30 |
Last Update Date | 2024-11-08 |