| NPI | 1205368990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 1050917) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NC 290618) |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2022-05-19 |