| NPI | 1023413556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP126754) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95009720) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95009720) | |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2022-11-04 |