| NPI | 1780447623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX 1152695) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1152695) |
| Enumeration Date | 2024-02-02 |
| Last Update Date | 2026-03-05 |