| NPI | 1104542851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1095994) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX 1095994) |
| Enumeration Date | 2022-10-14 |
| Last Update Date | 2024-02-16 |