| NPI | 1528751419 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TX 774680) | 
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1124307) | 
| Enumeration Date | 2023-05-29 | 
| Last Update Date | 2023-06-12 |