| NPI | 1083105506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 6444066-4405) |
| Additional Taxonomies | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: UT 6444066-3102) |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2019-05-14 |