| NPI | 1831839083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX 1034630) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1034630) |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2024-08-08 |