NPI | 1245586965 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2022026702) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2010026683) |
163W00000X Registered Nurse (Licence: OR 201241345RN) | |
Enumeration Date | 2012-07-31 |
Last Update Date | 2024-02-29 |