| NPI | 1336667393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP140858) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F342059-1) |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2019-10-01 |