| NPI | 1962805028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1123009) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM CNP-02650) |
| Enumeration Date | 2014-10-03 |
| Last Update Date | 2025-10-17 |