| NPI | 1083328504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1094957) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: RI 03547) |
| Enumeration Date | 2023-01-10 |
| Last Update Date | 2023-05-15 |