| NPI | 1003695636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1138185) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 20203089235) |
| Enumeration Date | 2023-09-25 |
| Last Update Date | 2024-02-28 |