NPI | 1972841856 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R140642) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R140642) |
363LF0000X Nurse Practitioner, Family (Licence: MD R140642) | |
Enumeration Date | 2013-01-28 |
Last Update Date | 2022-04-01 |