NPI | 1790230613 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN9275704) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9275704) |
Enumeration Date | 2016-08-20 |
Last Update Date | 2019-12-17 |