NPI | 1225163744 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5001612) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 200599) |
363LF0000X Nurse Practitioner, Family (Licence: NY 334577) | |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5001612) | |
Enumeration Date | 2007-02-23 |
Last Update Date | 2020-09-17 |