NPI | 1205576501 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R153830) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD 53830) |
Enumeration Date | 2022-04-01 |
Last Update Date | 2024-10-26 |