| NPI | 1104571512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1070775) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1070775) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1070775) | |
| Enumeration Date | 2022-02-14 |
| Last Update Date | 2022-10-19 |