| NPI | 1861110629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1086705) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID 73901) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10030790) | |
| Enumeration Date | 2022-08-18 |
| Last Update Date | 2024-08-13 |