NPI | 1629494711 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2022029286) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014003277) |
Enumeration Date | 2014-03-13 |
Last Update Date | 2022-07-28 |