| NPI | 1255817128 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP137887)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP137887)  | 
| Enumeration Date | 2018-07-13 | 
| Last Update Date | 2021-04-14 |