| NPI | 1114550621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 33490) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 811894) |
| Enumeration Date | 2020-02-13 |
| Last Update Date | 2020-03-04 |