| NPI | 1326519018 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 373543-4405) | 
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: UT 373543-4405) | 
| Enumeration Date | 2018-12-06 | 
| Last Update Date | 2021-10-21 |