NPI | 1295325223 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA 61143335) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 66454) |
Enumeration Date | 2021-01-23 |
Last Update Date | 2021-12-01 |