| NPI | 1104697689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1169433) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95177128) |
| Enumeration Date | 2024-01-12 |
| Last Update Date | 2024-09-27 |