| NPI | 1053021089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1109486) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH 00044410) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 295661) | |
| Enumeration Date | 2022-11-30 |
| Last Update Date | 2024-06-04 |