| NPI | 1235680406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP132449) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 817452) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: TX AP132449) | |
| Enumeration Date | 2016-10-21 |
| Last Update Date | 2022-02-05 |