| NPI | 1003302548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: UT 294366-8900) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: UT 294366-4405) |
| 363LF0000X Nurse Practitioner Family (Licence: UT 294366-8900) | |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2021-01-13 |