| NPI | 1073029567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX F12170454) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 765427) |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2018-01-02 |