| NPI | 1386305969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX PA15909) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA15909) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2022-01-05 |
| Last Update Date | 2024-11-12 |