NPI | 1265103089 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R221458) |
Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: MD R221458) |
Enumeration Date | 2021-09-22 |
Last Update Date | 2023-11-18 |