NPI | 1487046140 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: KS 5378284012) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015006330) |
Enumeration Date | 2015-03-04 |
Last Update Date | 2023-12-15 |