NPI | 1194323410 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 323998) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN174257) |
363L00000X Nurse Practitioner (Licence: NC 5013790) | |
Enumeration Date | 2020-10-09 |
Last Update Date | 2025-07-08 |