NPI | 1124417142 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11011098) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AR a004275) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11011098) | |
Enumeration Date | 2015-01-14 |
Last Update Date | 2023-03-07 |