| NPI | 1164768925 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1058508)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 666513)  | 
| Enumeration Date | 2012-12-26 | 
| Last Update Date | 2022-12-06 |