NPI | 1225566128 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 902057) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MS 902057) |
363LF0000X Nurse Practitioner, Family (Licence: NY 355362) | |
Enumeration Date | 2017-05-23 |
Last Update Date | 2024-10-28 |