NPI | 1730724295 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71010248A) |
Additional Taxonomies | 163WC1400X Registered Nurse, College Health (Licence: IN 28196190A) |
Enumeration Date | 2019-11-08 |
Last Update Date | 2020-08-20 |