NPI | 1912304759 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN9167756) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9167756) |
Enumeration Date | 2014-11-21 |
Last Update Date | 2021-10-19 |