NPI | 1508365123 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: GA RN210846) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: GA RN210846) |
Enumeration Date | 2018-02-09 |
Last Update Date | 2022-07-12 |