| NPI | 1619483468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1134547) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95028475) |
| Enumeration Date | 2017-12-15 |
| Last Update Date | 2024-12-17 |