| NPI | 1528719911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1154136) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-180668) |
| Enumeration Date | 2022-01-17 |
| Last Update Date | 2024-07-07 |