NPI | 1124502018 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 9246110) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9246110) |
363LF0000X Nurse Practitioner, Family (Licence: FL 9246110) | |
Enumeration Date | 2018-09-18 |
Last Update Date | 2022-06-14 |