| NPI | 1194415026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1109772) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: TX 1109772) |
| Enumeration Date | 2023-05-12 |
| Last Update Date | 2023-05-12 |