| 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) | 
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95027635) | |
| Enumeration Date | 2017-12-15 | 
| Last Update Date | 2025-03-12 |