| NPI | 1184202525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1068757) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1068757) |
| 363LF0000X Nurse Practitioner, Family (Licence: LA 218910) | |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2026-03-16 |