NPI | 1124572011 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9330256) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN9330256) |
Enumeration Date | 2016-08-08 |
Last Update Date | 2024-09-12 |