NPI | 1790102044 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 25364) |
Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: SC 211333) |
363LF0000X Nurse Practitioner, Family (Licence: SC 25364) | |
Enumeration Date | 2014-03-25 |
Last Update Date | 2025-06-27 |