NPI | 1578963088 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 9456593) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP126283) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5007428) | |
Enumeration Date | 2014-09-03 |
Last Update Date | 2018-09-19 |