| NPI | 1265068126 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1000136) | 
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 10041) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-22 | 
| Last Update Date | 2023-02-15 |