| NPI | 1033855507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1079279) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 862567) |
| Enumeration Date | 2022-05-09 |
| Last Update Date | 2022-09-29 |