NPI | 1164180543 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11016509) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: FL APRN11016509) |
207QA0000X Family Medicine, Adolescent Medicine (Licence: FL APRN11016509) | |
Enumeration Date | 2021-12-02 |
Last Update Date | 2024-10-25 |