NPI | 1629686027 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11012976) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9454129) |
Enumeration Date | 2020-07-21 |
Last Update Date | 2023-04-12 |