NPI | 1609311380 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9292479) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL Arnp 9292479) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 9292479) | |
Enumeration Date | 2017-01-04 |
Last Update Date | 2023-04-18 |