| NPI | 1356815856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1058908) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 898409) |
| Enumeration Date | 2019-01-17 |
| Last Update Date | 2022-03-30 |