NPI | 1972031342 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN113662) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA rn113662) |
Enumeration Date | 2017-05-31 |
Last Update Date | 2025-04-15 |