NPI | 1174096614 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11000836) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL APRN11000836) |
Enumeration Date | 2019-01-08 |
Last Update Date | 2025-02-06 |