| NPI | 1114353588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1046802) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1046802) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171160) | |
| Enumeration Date | 2013-09-17 |
| Last Update Date | 2022-01-18 |