| NPI | 1811571474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 275942-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 275942-3102) |
| 363L00000X Nurse Practitioner (Licence: UT 275942-4405) | |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2021-12-20 |