| NPI | 1093110561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL PA9108250) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA09723) |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2025-08-12 |