NPI | 1548401706 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD 2012005172) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD 2008011658) |
163W00000X Registered Nurse (Licence: MN R-153536-7) | |
Enumeration Date | 2009-03-18 |
Last Update Date | 2024-08-29 |