| NPI | 1669403218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/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 |