NPI | 1881256378 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 235897) |
Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: AZ 165853) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 235897) | |
Enumeration Date | 2019-07-03 |
Last Update Date | 2020-12-21 |