| NPI | 1316590110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 57721) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP142255) |
| Enumeration Date | 2019-07-20 |
| Last Update Date | 2021-10-11 |