NPI | 1730639535 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R193702) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R198702) |
Enumeration Date | 2016-10-05 |
Last Update Date | 2020-08-12 |