| NPI | 1851021604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 6505349-4405) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: UT 6505349-4405) |
| Enumeration Date | 2022-06-14 |
| Last Update Date | 2022-07-06 |