| NPI | 1447636188 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 7771579-4405)  | 
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 77715794405)  | 
| Enumeration Date | 2015-08-05 | 
| Last Update Date | 2019-09-20 |