| NPI | 1669403218 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA 04576)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 722355)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: LA 83778AP04576)  | |
| 363LF0000X Nurse Practitioner, Family (Licence: NM 02068)  | |
| Enumeration Date | 2006-07-05 | 
| Last Update Date | 2022-02-18 |