NPI | 1639822703 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX F01221063) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NH 092807-23) |
Enumeration Date | 2022-01-30 |
Last Update Date | 2024-07-12 |