NPI | 1104701366 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10050055) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL APRN11040949) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11040949) | |
Enumeration Date | 2025-08-07 |
Last Update Date | 2025-09-17 |