| NPI | 1659925915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: UT 9015159-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 9015159-3102) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: UT 9015159-8900) | |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2021-11-11 |