NPI | 1346752433 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MD 2017019195) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R143807) |
Enumeration Date | 2017-10-29 |
Last Update Date | 2021-05-20 |