NPI | 1447629407 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015034678) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 154681) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2018021089) | |
Enumeration Date | 2015-09-21 |
Last Update Date | 2020-11-19 |