NPI | 1619403359 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11036970) |
Additional Taxonomies | 283Q00000X Psychiatric Hospital (Licence: FL rn9314127) |
Enumeration Date | 2017-05-01 |
Last Update Date | 2025-01-08 |