| NPI | 1801352174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 6209243-4405) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 6209243-4405) |
| 363LF0000X Nurse Practitioner, Family (Licence: UT 6209243-4405) | |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2021-03-24 |