NPI | 1972964229 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA AP08681) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA AP08681) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1019032) | |
Enumeration Date | 2016-03-15 |
Last Update Date | 2022-03-01 |