| NPI | 1063136174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 9811459-8900) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: UT 9811459-3102) |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2022-10-03 |