| NPI | 1760109342 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1112710)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041517220)  | 
| Enumeration Date | 2022-10-24 | 
| Last Update Date | 2025-06-27 |