NPI | 1558905331 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11004299) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11004299) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1179319) | |
Enumeration Date | 2019-11-04 |
Last Update Date | 2025-05-28 |