| NPI | 1265026801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 1029244) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX D5793) |
| Enumeration Date | 2021-02-24 |
| Last Update Date | 2021-02-24 |