| NPI | 1376004317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1376004317) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA 210750) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX F03190337) | |
| Enumeration Date | 2019-03-30 |
| Last Update Date | 2022-09-28 |