| NPI | 1821368713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1069023) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 652275) |
| 163W00000X Registered Nurse (Licence: MD R196685) | |
| Enumeration Date | 2012-01-09 |
| Last Update Date | 2022-02-15 |