| NPI | 1174157713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP142516) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX AP142516) |
| 207R00000X Internal Medicine (Licence: TX AP142516) | |
| Enumeration Date | 2020-02-22 |
| Last Update Date | 2021-05-19 |