| NPI | 1205409042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1032178) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1032178) |
| Enumeration Date | 2021-07-20 |
| Last Update Date | 2024-05-22 |