NPI | 1629445705 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009673) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71008453A) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3009673) | |
Enumeration Date | 2015-08-25 |
Last Update Date | 2024-02-06 |