| NPI | 1104115286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP120123) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 510876) |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2022-10-08 |