NPI | 1255780003 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 24803) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 231093) |
163W00000X Registered Nurse (Licence: OH 419734) | |
Enumeration Date | 2016-06-11 |
Last Update Date | 2022-01-13 |