| NPI | 1023496726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 202006251NP-PP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP127791) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 697530) | |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2022-08-03 |