NPI | 1104474428 |
---|---|
Other Name | KRYSTAL NICOLE HOWARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024178525) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD R193425) |
Enumeration Date | 2019-08-29 |
Last Update Date | 2020-01-16 |