NPI | 1962156190 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MS 2023192642) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 2023192642) |
363LF0000X Nurse Practitioner, Family (Licence: MS 905144) | |
363LP2300X Nurse Practitioner, Primary Care (Licence: MS 905144) | |
Enumeration Date | 2022-02-07 |
Last Update Date | 2025-03-03 |