| NPI | 1518343110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 9602184-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 805775) |
| Enumeration Date | 2015-08-05 |
| Last Update Date | 2016-01-04 |