| NPI | 1114596806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1051685) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: TX 801739) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 11434-33) | |
| Enumeration Date | 2021-06-18 |
| Last Update Date | 2021-12-21 |