| NPI | 1245792837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5012595) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP140517) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2019-12-04 |