| NPI | 1861044604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 8632096-4405) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 8632096-4405) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 8632096-8900) | |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2021-09-29 |