| NPI | 1023715380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 11768869-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 11768869-3102) |
| Enumeration Date | 2023-02-07 |
| Last Update Date | 2023-07-12 |