NPI | 1275007510 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MS 904366) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS 894365) |
Enumeration Date | 2019-01-21 |
Last Update Date | 2021-07-27 |