NPI | 1255963070 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11004581) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11004581) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11004581) | |
Enumeration Date | 2020-02-10 |
Last Update Date | 2024-05-09 |