NPI | 1104712975 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NM 64056) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM 64056) |
Enumeration Date | 2025-06-17 |
Last Update Date | 2025-08-14 |