NPI | 1508309329 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2007018588) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2007018588) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 78074) | |
Enumeration Date | 2016-11-28 |
Last Update Date | 2024-12-31 |