| NPI | 1275033664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP136541) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704368570) |
| Enumeration Date | 2018-02-13 |
| Last Update Date | 2020-11-12 |