NPI | 1104298272 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 27068) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 206403) |
Enumeration Date | 2015-10-28 |
Last Update Date | 2020-03-26 |