NPI | 1194407403 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1130602) |
Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: TX 1130602) |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX 1130602) | |
Enumeration Date | 2023-08-04 |
Last Update Date | 2023-09-10 |