NPI | 1871022897 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R170057) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA SP017535) |
363L00000X Nurse Practitioner (Licence: PA SP017535) | |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R170057) | |
Enumeration Date | 2017-06-05 |
Last Update Date | 2021-04-19 |