NPI | 1639414337 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN9270405) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9270405) |
Enumeration Date | 2012-12-06 |
Last Update Date | 2024-07-01 |