| NPI | 1932521440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1012302) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 680374) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OK 200979) | |
| Enumeration Date | 2014-01-17 |
| Last Update Date | 2021-06-25 |