| NPI | 1114459732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP133854) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024184318) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX F03170517) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024184318) | |
| Enumeration Date | 2017-04-02 |
| Last Update Date | 2024-10-02 |