| NPI | 1104980093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 225538) |
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: TX 225538) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2007-07-08 |