NPI | 1104366061 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN201760) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN201760) |
Enumeration Date | 2017-02-26 |
Last Update Date | 2022-10-02 |