| NPI | 1790836344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 680899) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 680899) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 680899) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2023-10-23 |