| NPI | 1043236383 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 440977)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 061008)  | 
| 363L00000X Nurse Practitioner (Licence: TX 440977)  | |
| 363L00000X Nurse Practitioner (Licence: TX N4358)  | |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 440977)  | |
| Enumeration Date | 2006-07-13 | 
| Last Update Date | 2012-07-16 |