NPI | 1194202614 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11007274) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11007274) |
363LF0000X Nurse Practitioner, Family (Licence: TN 24462) | |
Enumeration Date | 2018-07-26 |
Last Update Date | 2024-06-24 |