NPI | 1417592205 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 23336) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 23336) |
363LF0000X Nurse Practitioner, Family (Licence: GA RN262065) | |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN262065) | |
Enumeration Date | 2019-11-15 |
Last Update Date | 2024-11-04 |