NPI | 1699256453 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN9410570) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F07181219) |
Enumeration Date | 2018-08-28 |
Last Update Date | 2021-04-05 |