| NPI | 1225680895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11012372) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX AP142382) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP142382) | |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2024-06-21 |