| NPI | 1730217167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 5142656-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 5142656-4405) |
| 363LF0000X Nurse Practitioner, Family (Licence: UT 5142656-4405) | |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-12-04 |