| NPI | 1215491295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1020058) |
| Additional Taxonomies | 163WP2201X Registered Nurse, Ambulatory Care (Licence: MO 2010018966) |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2020-11-20 |