NPI | 1114443702 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11013541) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 342188) |
363LF0000X Nurse Practitioner, Family (Licence: NY 342188) | |
363LF0000X Nurse Practitioner, Family (Licence: FL APRN11013541) | |
Enumeration Date | 2017-08-16 |
Last Update Date | 2025-10-03 |