| NPI | 1750848057 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 2024061917) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP140455) | 
| Enumeration Date | 2019-02-23 | 
| Last Update Date | 2024-07-19 |