| NPI | 1992042212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2023003905) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2012039129) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP122985) | |
| Enumeration Date | 2013-01-07 |
| Last Update Date | 2024-12-09 |