| NPI | 1184952822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT MS2073992) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 220632-4405) |
| 363L00000X Nurse Practitioner (Licence: UT 220632-8900) | |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2025-10-08 |