| NPI | 1467966374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP135902) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 644295) |
| Enumeration Date | 2017-11-30 |
| Last Update Date | 2024-09-03 |