| NPI | 1144876749 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX F07190383) | 
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: TX 808534) | 
| Enumeration Date | 2019-08-11 | 
| Last Update Date | 2019-08-12 |