NPI | 1134111057 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5000964) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5000964) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 4181) | |
Enumeration Date | 2005-08-17 |
Last Update Date | 2019-11-15 |