NPI | 1306289459 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 13744-33) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 13744-33) |
163W00000X Registered Nurse (Licence: WI 201017-30) | |
Enumeration Date | 2013-04-08 |
Last Update Date | 2025-10-02 |