NPI | 1972005189 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 259944) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP136537) |
363LF0000X Nurse Practitioner, Family (Licence: AZ 259944) | |
Enumeration Date | 2018-03-03 |
Last Update Date | 2023-08-21 |