| NPI | 1710524392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1030800) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1030800) |
| 163W00000X Registered Nurse (Licence: TX 682547) | |
| Enumeration Date | 2019-12-03 |
| Last Update Date | 2024-11-13 |