| NPI | 1912567504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R210157) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R210157) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP141853) | |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2023-08-24 |