| NPI | 1376773556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 6036252-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 6036252-4408) |
| 363LF0000X Nurse Practitioner, Family (Licence: UT 6036252-4405) | |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2021-12-01 |