| NPI | 1114685690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1059125) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 1059125) |
| Enumeration Date | 2021-12-02 |
| Last Update Date | 2025-07-16 |