| NPI | 1891262838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1005210) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1005210) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 7889) | |
| Enumeration Date | 2018-10-29 |
| Last Update Date | 2025-07-15 |