NPI | 1245625649 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R194475) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R194475) |
Enumeration Date | 2015-04-02 |
Last Update Date | 2019-09-18 |