| NPI | 1275112567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1048220) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 907623) |
| 363L00000X Nurse Practitioner (Licence: TX 1048220) | |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2021-08-02 |