NPI | 1205468030 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R196829) |
Additional Taxonomies | 163WG0600X Registered Nurse, Gerontology (Licence: MD R196829) |
363LG0600X Nurse Practitioner, Gerontology (Licence: MD R196829) | |
Enumeration Date | 2020-02-10 |
Last Update Date | 2024-09-10 |