| NPI | 1124783642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1038831) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 1038831) |
| Enumeration Date | 2021-11-01 |
| Last Update Date | 2021-11-01 |