NPI | 1720411432 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R219103) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: DE L1-0043098) |
163W00000X Registered Nurse (Licence: PA RN642929) | |
363L00000X Nurse Practitioner (Licence: MD R219103) | |
Enumeration Date | 2013-08-16 |
Last Update Date | 2024-04-06 |