| NPI | 1720506942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: UT 2017020069) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: UT 2017020069) |
| Enumeration Date | 2017-09-07 |
| Last Update Date | 2018-11-27 |