NPI | 1124053632 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 446681) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 446681) |
Enumeration Date | 2006-07-12 |
Last Update Date | 2021-08-18 |