NPI | 1578193637 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2020001756) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AR 219140) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 53-82623-061) | |
Enumeration Date | 2020-01-16 |
Last Update Date | 2024-04-09 |