NPI | 1326635970 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11010245) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL ARPN11010245) |
Enumeration Date | 2020-12-30 |
Last Update Date | 2023-07-27 |