| NPI | 1063148195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1094316) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 947531) |
| Enumeration Date | 2022-07-29 |
| Last Update Date | 2023-06-03 |