| NPI | 1053173849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1155416) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL aprn11030827) |
| Enumeration Date | 2024-01-26 |
| Last Update Date | 2024-08-06 |