| NPI | 1578349338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1120093) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1120093) |
| Enumeration Date | 2023-09-06 |
| Last Update Date | 2024-11-15 |