| NPI | 1124799978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1057819) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11015474) |
| Enumeration Date | 2021-09-22 |
| Last Update Date | 2023-11-29 |