| NPI | 1043835630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 76679454405) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: UT 7667945-3102) |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-06-30 |