NPI | 1174027601 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP11179) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP136386) |
Enumeration Date | 2018-03-20 |
Last Update Date | 2024-07-17 |