| NPI | 1114610219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1123564) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX F04230330) |
| Enumeration Date | 2023-06-02 |
| Last Update Date | 2023-06-02 |