NPI | 1790406601 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704282097NSA230V7) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704282097) |
Enumeration Date | 2022-09-08 |
Last Update Date | 2023-10-12 |