NPI | 1720647035 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN187184) |
Additional Taxonomies | 174H00000X Health Educator (Licence: CA W51662) |
363LF0000X Nurse Practitioner, Family (Licence: MD AC002764) | |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD AC005185) | |
Enumeration Date | 2019-06-10 |
Last Update Date | 2023-03-16 |