| NPI | 1063965978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP131092) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: TX AP131092) |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2020-11-30 |