NPI | 1780131649 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: VA 0001189033) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173910) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0001189033) | |
Enumeration Date | 2016-09-07 |
Last Update Date | 2022-03-16 |