| NPI | 1992161244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP130804) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ TAP8335) |
| Enumeration Date | 2015-12-31 |
| Last Update Date | 2021-10-18 |