| NPI | 1164850798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP124619) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 584109) |
| Enumeration Date | 2013-10-16 |
| Last Update Date | 2021-03-22 |