| NPI | 1649770686 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1110782) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 890563) | 
| Enumeration Date | 2018-02-16 | 
| Last Update Date | 2023-05-05 |