| NPI | 1205424694 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1035445) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL rn9387682) | 
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN301656) | |
| Enumeration Date | 2021-01-02 | 
| Last Update Date | 2024-10-11 |