| NPI | 1124523295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 6617051-4405) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: UT 6617051-3102) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2022-07-23 |