| NPI | 1245755479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP134820) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO C-RXN.0001363-C-NP) |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2021-06-01 |