NPI | 1639617376 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11214) |
Additional Taxonomies | 363A00000X Physician Assistant |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX MED-PAC-LIC-76233) | |
Enumeration Date | 2017-02-02 |
Last Update Date | 2019-08-01 |