| NPI | 1801489372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1030111) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 1030111) |
| Enumeration Date | 2021-02-16 |
| Last Update Date | 2024-11-06 |