| NPI | 1700275492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 683070) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX F1014454) |
| Enumeration Date | 2015-01-18 |
| Last Update Date | 2024-11-12 |