| NPI | 1831615145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 346555-4405) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 346555-8900) |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2018-03-17 |