| NPI | 1760941207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1057612) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AG07180188) |
| Enumeration Date | 2019-03-14 |
| Last Update Date | 2024-11-21 |