NPI | 1104470038 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11003519) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5019367) |
363LF0000X Nurse Practitioner, Family (Licence: FL APRN11003519) | |
Enumeration Date | 2019-07-29 |
Last Update Date | 2024-10-02 |