| NPI | 1336801323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1056901) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 739101) |
| 207Q00000X Family Medicine (Licence: TX 1056901) | |
| Enumeration Date | 2021-10-07 |
| Last Update Date | 2022-11-03 |