NPI | 1720343767 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: GA RN253774) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 187432) |
Enumeration Date | 2012-07-05 |
Last Update Date | 2018-09-19 |